Application Of Shear Wave Elastography In Diagnosis And Ultrasonic Classification Of Hashimoto’s Thyroiditis

Objective:Using shear wave elastography(SWE),analyze the differences in shear wave elastography values among different ultrasound and clinical subtypes of Hashimoto’s thyroiditis(HT)patients,and explore the correlation between thyroid shear wave elastography values,gland thickness,and laboratory indicators,providing theoretical basis for clinical judgment of the progression and prognosis of HT disease.Methods:Select 91 HT patients diagnosed at the first hospital of Nan Chang from January2021 to December 2022,including 14 males and 77 females,perform routine ultrasound,shear wave elastography examinations and thyroid function tests on them.According to conventional ultrasound images,patients were divided into HT-Ⅰ type(16 cases),HT-Ⅱ type(37 cases),HT-Ⅲ type(24 cases),HT-Ⅳ type(14 cases);According to the five measurements of thyroid function,91 patients with HT were divided into HT normal hypothyroidism(37 cases),HT hyperthyroidism(17 cases),HT subclinical hypothyroidism(29 cases)and HT hypothyroidism(8 cases);Select healthy individuals with normal thyroid tissue during the same period as the control group(50 cases).First,observe the echo and blood flow of the thyroid gland,measure the size of the thyroid gland lobe and the thickness of the isthmus,and observe whether the neck lymph nodes in the neck region Ⅵ were present,and recorded.Then take the longitudinal section of the thyroid,gently touch the skin with the probe,Activate Elasto imaging and select the shear wave elastography(SWE)mode,adjust the diameter of the area of interest(ROI)to 5mm,and place it at the upper,middle and lower poles of the thyroid on one side,and advise the patient to hold their breath,refrain from swallowing,and not speak.When the image stability on the display screen is 4-5 stars,and the reliability is more than 90%,freeze the image and measure the average elastic value(Emean),the maximum elastic value(Emax),the minimum elastic value(Emin),and the standard deviation(SD),Take 10 qualified images to calculate the mean value for statistics.Results:1.Among 91 HT patients,the patients of HT-Ⅰ type are mainly consists of patients with normal thyroid function(62.5%);The patients with HT-Ⅱ type mainly consists of patients with normal thyroid function(37.8%);The patients with HT-Ⅲ type mainly consists of patients with subclinical hypothyroidism and hypothyroidism(29.1%);The patients with HT-Ⅳ type mainly consists of patients with normal thyroid function(57.1%).The patients with HT of grade 1 blood flow are mainly consists of patients with normal thyroid function(55.8%);The patients with grade 2 blood flow HT were mainly consists of patients with subclinical hypothyroidi-sm(43.7%);The patients with grade 3 blood flow HT were mainly consists of hyperthyroidi-sm(81.2%).2.Compare the different thyroid elasticity indexes between HT group and normal control group,the levels of thyroid elasticity parameters Emean,Emax,Emin and Esd in HT group were significantly higher than those in control group(P<0.01),and the differences were statistically significant.3.There was significant difference in the average thyroid elastic value Emean between the control group and the HT group.There was significant difference in the average thyroid elastic value of each ultrasonic type and clinical stage between the control group and the HT group(P<0.01).The average thyroid elastic value Emean of the control group,HT-Ⅰ type,HT-Ⅳ type,HT-Ⅱ type,and HT-Ⅲ type increased sequentially;The average thyroid elastic Emean values in the control group,HT hyperthyroidism stage,HT normal thyroid function stage,HT subclinical hypothyroidism stage,and HT hypothyroidism stage increased sequentially.4.The thyroid ultrasound elastic parameter Emean had a good predictive effect on the occurrence of HT disease.The area under the curve(AUC)was 0.927(P<0.05).The critical value of thyroid ultrasound elastic parameter Emean in diagnosing HT disease was 19.44 KPa,the sensitivity was 0.90,and the specificity was 0.84.5.Among 91 HT patients,Emean had a positive correlation with thyroid isthmus thickness(rs=0.417),a positive correlation with TSH titer(rs=0.386),and a weak correlation with thyroid gland thickness(rs=0.276),no correlation with TPOAb and TgAb titers.6.There was a statistically significant difference in the detection rate of cervical region Ⅵ lymph nodes between the control group and the HT group(P<0.01).Conclusion:1.Shear wave elastography has certain application value in Hashimoto’s thyroiditis,providing specific shear wave elastic reference values for HT patients,evaluating the hardness changes of thyroid tissue,and providing theoretical basis for clinical diagnosis and treatment.2.Shear wave elastography can further refine the ultrasound classification of Hashimoto’s thyroiditis patients,evaluate the degree of fibrosis in thyroid tissue of HT patients with different ultrasound classifications,and better judge the progression and prognosis of HT disease.